Estimated to occur in one infant of every 300 live births, Congenital Muscular Torticollis (CMT) is the third most common congenital musculoskeletal anomaly after congenital hip dysplasia and club foot as all three congenital deformities are associated with fetal intrauterine malposition and often co-exist with torticollis. Acquired positional Plagiocephaly may contribute to torticollis, or may result from unaddressed torticollis, and a spike in incidence has occurred ever since the American Academy of Pediatrics initiated the Safe-to-Sleep campaign launched in 1994.

Understand the postulated etiologies of torticollis and the accompanying craniofacial, ocular asymmetries and deformities and compensations which result in compensatory posture or scoliosis. Learn about the kinesiology of the sternocleidomastoid muscle, and how its two-headed origin endows it with dual extensor-flexor function during unilateral contraction, as well as why one sided shortening with or without pseudotumor causes ipsilateral tilt and contralateral rotation. Discern how this congenital muscular deformity negatively impacts on the achievement of gross motor skills especially diminished head control in anti-gravity positions, and abnormal movement such uneven weight shifting through the trunk, and asymmetrical transition movements. Absorb why delayed acquisition of gross motor milestones will result in a cascading delay in the acquisition of milestones in all other developmental domains.

Therapists will learn about classification, diagnosis, and how sequelae may result in changing of the level asymmetric placement of the relative ear and eye position, eye strain, mandibular deviation, and even facial hypoplasia if left untreated. Become familiar with the various treatments for both torticollis and acquired plagiocephaly, and why parental passive stretching is not always an effective carryover program.

This primer is a MUST READ for all early intervention and pre-school therapists who service the professional needs of the infant, toddler, and child with torticollis or developmental plagiocephaly.

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EITTOC is an approved provided of Continuing Education by the American Occupational Therapy Association, Inc. EITOC is authorized to offer 0.55 AOTA CEU's/5.5 Contact Hours. The assignment of AOTACEU's does not imply endorsement of specific course content, products, or clinical procedures by AOTA.

APPROVED BY THE ILLINOIS EARLY INTERVENTION TRAINING PROGRAM FOR EARLY INTERVENTION CREDENTIAL CREDIT for 3.0 Hours

Approved as a Core of Knowledge Training by the Office of Childcare: Maryland State Department of Education

- This activity is pending approval from the National Association of Social Workers (NASW) –

Disclosure: David C Saidoff PT - course developer/presenter - has the following relevant financial relationships to disclose: he receives monetary compensation for the preparation of this course, in addition to a percentage of company sales, and has the following relevant non-financial relationships to disclose: EITTOC Board of Directors: volunteer member. Melissa Whelan, OTR - course developer/presenter - has the following relevant financial relationships to disclose: she receives monetary compensation for the preparation of this course, in addition to a percentage of company sales, and has the following relevant non-financial relationships to disclose: EITTOC Board of Directors: volunteer member. Dr. Robert Koppel, M.D.,FAAP, Diplomate of the American Board of Pediatrics has the following relevant financial relationships to disclose: he receives monetary compensation for the preparation of this course, in addition to a percentage of company sales, and has the following relevant non-financial relationships to disclose: EITTOC Board of Directors: volunteer member. Declaration: Approval of this course does not necessarily imply that any of the governing bodies (e.g., West Virginian Board of Physical Therapy, or other such governmental or NGO’s supports the views of the presenter or sponsor. Information provided should be used within the scope of practice. No relevant financial or non-financial relationships exists between EITTOC or the products discussed any course; no such relationship or endorsement exists for any products mentioned in any courses sponsored by EITTOC, or in any of the items (such as specific AED or Epinephrine injection product) or any testing instrument used to evaluate children; the above course is specific to said-topic, and may not be extrapolated to any other course or topic outside the scope of this course. Course instructor(s) have no other financial or non-financial remuneration - whether prior to or following course delivery; the above advertisement is made available to all physical therapy (and other) licensee on a non-discriminatory basis. Ascend has approved this course and may be contacted about any concerns. Information provided should be used within scope of practice. AOTA does not endorse specific course content, products, or clinical procedures. The onus of responsibility for this course – granted contact hours by the AOTA – is for each OT professional to check with their State board of OT to see if this course meets licensure requirement for continuing education.

Note: The above advertisement is made available to all physcial therapy licensees on a non-discriminatory basis

*Ohio Physical Therapists and PTA's are awarded 4 hours - 0.40 CEU for this course - Approval of this course does not necessarily imply that the WV Board of Physical Therapy supports the views of the presenter or sponsor. *This course meets the basic criteria of the Maryland Board of Physical Therapy Examiners for 0.5 CEU’s.

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Congenital Muscular Torticollis and Acquired Plagiocephaly Primer in Early Intervention and Pre-School

Course intent: To provide occupational & physical therapists with the clinical background to understand the clinically relevant issues regarding obstetrical torticollis and plagiocephaly so as to implement appropriate therapeutic intervention in the fine motor, motor, and adaptive domains, as well as management and prevention of compensatory substitution postures.

Relevance to occupational & physical therapy: Physical & occupational therapists in the early intervention setting are on the front line of treating children with torticollis and plagiocephaly, whether in the neonatal intensive care unit, or the baby nursery at hospitals, but especially when visiting the home in the early intervention setting.

Provider will be able to: Identify compensatory craniofacial, upper trunk and spinal torsions and rotations if untreated

Provider will be able to: Provider will be able to: Identify all components of a comprehensive therapeutic regimen including passive stretching and active range of motion in ways that facilitates stretching of the contractured SCM

Provider will be able to: Implement all other secondary and relevant treatment modalities to facilitate resolution of torticollis, which include anti-gravity positioning, botox injections, and cervical collar usage

Provider will be able to: Implement recruitment of age related gains in equilibrium and righting reactions to facilitate stretching of the weak SCM, and stretching of the tight SCM

Provider will be able to: Implement all positional and orthotic interventions which will stave off the worsening of plagiocephaly, while dynamically remolding the head

Provider will be able to: Identity which treatment activities should not be part of the parental home exercise program carryover because of potential and unintended harm to the child’s neck and spine

Classification Codes: Category 1: Domain of OT

Areas of occupation: Play [play exploration] Social Participation [Family]

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